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Can Metformin Be Taken Before Gastric Bypass Surgery?
Question: preop gastric bypass surgery I was taking Morning-Dapaglitizone ,metformin 500,Human mixtard 50/50 & in night humalog 25/75,metformin 500mg, Postop gastric bypass 6thweek running not taken any diabetic related drugs from day of surgery today my fasting is 135 & pp is 180 do u suggest to start at least metformin or should I wait? preop I was 107 kgs today I am 88kgs
Brief Answer:
Diabetes
Detailed Answer:
It is not the objective of this forum to give exact medication names and doses.
One of the reasons is that this requires the opportunity to examine the patient in-person in addition to several follow up visits to determine best choice of treatment with dose adjustments.
However, I follow what you are asking here.
When I see someone like you in my practice, I order the following tests in addition to a thorough physical examination:
CBC
HbA1c
Lipids
Electrolytes
Kidney function tests
Liver Function tests
TSH
25 hydroxy Vitamin D
Vitamin B12
Calcium
Iron studies
Albumin
Fructosamine
If the kidneys are fen, and there are no signs of heart/lung/liver failure then metformin can be considered
Diabetes
Detailed Answer:
It is not the objective of this forum to give exact medication names and doses.
One of the reasons is that this requires the opportunity to examine the patient in-person in addition to several follow up visits to determine best choice of treatment with dose adjustments.
However, I follow what you are asking here.
When I see someone like you in my practice, I order the following tests in addition to a thorough physical examination:
CBC
HbA1c
Lipids
Electrolytes
Kidney function tests
Liver Function tests
TSH
25 hydroxy Vitamin D
Vitamin B12
Calcium
Iron studies
Albumin
Fructosamine
If the kidneys are fen, and there are no signs of heart/lung/liver failure then metformin can be considered
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
all the functions are normal Dr.Except HbA1c which is 7.5 but since it's only 6th week of postop whether this avg reading can be considered?
Brief Answer:
Follow up
Detailed Answer:
You are correct in surmising the 3 month averaging of glucoses reflected in HbA1c.
So yes at 6 weeks it is tad premature to act on it.
That is why I suggested Fructosamine above which is a 3 week average. But it does have the same rigorous standard as that of the A1c. So it is ok if you skip that.
At the moment , both options i.e. continuing no medication versus starting metformin (under the guidance of an endocrinologist in-person) are fair.
Either way keep an eye on your glucoses and if they remain close to target range then you are on the right track.
If the glucoses and A1c over time are excellent , you can always start withdrawing metformin in consultation with the endocrinologist.
Follow up
Detailed Answer:
You are correct in surmising the 3 month averaging of glucoses reflected in HbA1c.
So yes at 6 weeks it is tad premature to act on it.
That is why I suggested Fructosamine above which is a 3 week average. But it does have the same rigorous standard as that of the A1c. So it is ok if you skip that.
At the moment , both options i.e. continuing no medication versus starting metformin (under the guidance of an endocrinologist in-person) are fair.
Either way keep an eye on your glucoses and if they remain close to target range then you are on the right track.
If the glucoses and A1c over time are excellent , you can always start withdrawing metformin in consultation with the endocrinologist.
Note: For further follow-up, discuss your blood glucose reports with our diabetologist. Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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